Prospective sonographic evaluation of interleukin-2-induced changes in the gallbladder.
OBJECTIVE
To describe the changes in the gallbladder induced by interleukin-2 (IL-2) therapy and to correlate the findings with the clinical course.


METHODS
Twenty-five men with human immunodeficiency virus (HIV) infection were examined prospectively with right upper quadrant ultrasonography (US) before and after receiving IL-2 therapy. Four patients also underwent US after a second course of IL-2. The gallbladder was evaluated for wall thickening, echotexture, and intramural and pericholecystic fluid. Correlation was made between the clinical signs and symptoms, IL-2 dose, CD4 cell count, and the US appearance of the gallbladder.


RESULTS
There was significant correlation between symptoms of right upper quadrant pain during IL-2 therapy and US abnormalities of the gallbladder, including an increase in wall thickening (P = .012) and the development of intramural (P = .015) and pericholecystic (P = .006) fluid. More severe abnormalities were seen with higher IL-2 doses. All symptoms resolved with cessation of IL-2 therapy. In patients who underwent repeat US, the gallbladder reverted to a normal appearance. No correlation was found between the CD4 cell count and the development of symptoms or the US appearance of the gallbladder.


CONCLUSIONS
IL-2-induced changes resolve rapidly with cessation of therapy, and no surgical intervention is needed. These changes can be avoided or reduced by decreasing the IL-2 dose during subsequent cycles.
Premkumar
A
A
Department of Diagnostic Radiology, Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda, MD 20892-1182, USA.
Walworth
C M
CM
Vogel
S
S
Daryanani
K D
KD
Venzon
D J
DJ
Kovacs
J A
JA
Feuerstein
I M
IM
D015746:Abdominal Pain / Q000209:etiology; D000276:Adjuvants, Immunologic / Q000009:adverse effects* / Q000627:therapeutic use; D000328:Adult; D018791:CD4 Lymphocyte Count / Q000187:drug effects; D005704:Gallbladder / Q000000981:diagnostic imaging* / Q000187:drug effects*; D015658:HIV Infections / Q000000981:diagnostic imaging / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007376:Interleukin-2 / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography
D000276:Adjuvants, Immunologic; D007376:Interleukin-2